THE CEMENTED ALL-POLY TIBIA IN THE ACTIVE <60 PATIENT – OPPOSES

While the vast majority of total knee replacements performed throughout the world employ a modular metal-backed tibial tray, and not an all-polyethylene tray, this issue remains controversial.Proposed advantages to a metal-backed tray include: a) decreased bending strains, b) reduces compressive stresses in the cement and cancellous bone beneath the baseplate (especially in asymmetric loading), c) distributes load more evenly across the interfaceProposed advantages of an all-polyethylene tray include: a) cost reduction, b) reduced polyethylene thickness with the same amount of bone resection, c) increased tensile stresses at the interface during eccentric loadingThe challenge is at present we don't know the >10-year track record of current generation tibial components. This debate centers on the <60-year-old. This is the most difficult patient in total knee arthroplasty with higher revision rates than an older cohort.It makes sense to use an all-polyethylene tibia if the revision rates turn out to be simi...